Language Disorders

Language is made up of socially shared rules that include the following:

What words mean (e.g., “star” can refer to a bright object in the night sky or a celebrity)
How to make new words (e.g., friend, friendly, unfriendly)
How to put words together (e.g., “Peg walked to the new store” rather than “Peg walk store new”)
What word combinations are best in what situations (“Would you mind moving your foot?” could quickly change to “Get off my foot, please!” if the first request did not produce results)

When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.

What are some signs or symptoms of preschool language disorders?

Some children have problems with understanding, also called receptive language. They may have trouble:

Understanding what gestures mean
Following directions
Answering questions
Identifying objects and pictures
Taking turns when talking with others

Some children have problems talking, also called expressive language. They may have trouble:

Asking questions
Naming objects
Using gestures
Putting words together into sentences
Learning songs and rhymes
Using correct pronouns, like “he” or “they”
Knowing how to start a conversation and keep it going

Many children have problems with both understanding and talking. Some children also have trouble with early reading and writing, such as:

Holding a book right side up
Looking at pictures in a book and turning pages
Telling a story with a beginning, a middle, and an end
Making predictions
Understanding what is being read
Naming letters and numbers
Learning the alphabet

What if my child speaks more than one language?

A child does not get a language disorder from learning a second language. It won’t confuse your child to speak more than one language in the home. Speak to your child in the language that you know best. If your child has a language disorder, they will have difficulties communicating in all languages they are exposed to.

How are preschool language disorders evaluated?

Speech-language pathologists, also called SLPs, are usually part of a team. The team includes you, the child’s teacher, and other professionals. The team can see if your child’s language skills are at age level. SLPs evaluate young children while they play.

They want to know:

Does your child know what to do with toys?
Does your child use pretend play?

For understanding and talking, the SLP will see if your child:

Follows directions
Names common objects and actions
Knows colors, numbers, and letters
Follows routines like putting his coat away or sitting during circle time
Sings songs or repeats nursery rhymes
Gets needs met at home, during play, and at preschool

SLPs will see if your child’s speech is easy to understand. They will see how your child uses her lips, tongue, and teeth to make sounds. They will have your child imitate sounds or words.

For early reading and writing, the SLP will see if your child:

Looks at and talks about pictures in books
Recognizes familiar signs and logos
Holds a book correctly and turns the pages
Recognizes and writes his or her own name
Tries to write letters and numbers

How are preschool language disorders treated?

SLPs can help children with language disorders. They work on language problems found during the evaluation. They work with you, teachers, and other professionals to improve and develop speech and language skills. Good language skills help with learning, behavior, self- esteem, and social skills.

Here are some possible treatment goals:

Increase your child’s understanding and use of language
Teach caregivers, family members, and teachers ways to communicate with your child
Help your child use other ways to communicate when needed. This may include simple gestures, picture boards, or computers that say words out loud. This is also called augmentative and alternative communication, or AAC.

What can I do to help?

Here are some language tips:

- Talk a lot to your child. This will help your child learn new words.
- Read to your child every day. Point out words you see. Point to signs in the grocery store, at school, and outside.
- Speak to your child in the language you know best.
- Listen and respond when your child talks.
- Encourage your child to ask you questions.
- Give your child time to answer questions.
- Set limits for watching TV and using electronic media. Use the time for talking and reading together.

What causes preschool language disorders?

Often the cause of a language disorder in not known. Some causes of preschool language disorders may be:

- Family history of language disorders
- Premature birth
- Low birth weight
- Hearing loss
- Autism
- Intellectual disabilities
- Syndromes, like Down syndrome or Fragile X syndrome
- Fetal alcohol spectrum disorder
- Stroke
- Brain injury
- Tumors
- Cerebral palsy
- Poor nutrition
- Failure to thrive

What are the types of preschool language disorders?

Problems with understanding are called receptive language disorders. Problems with talking are called expressive language disorders. Children may have problems with both. Sometimes a language disorder is called specific language impairment, or SLI.

Types of preschool language disorders may include problems with:

Understanding basic concepts, questions, and directions
Learning new words
Saying words in the right order
Having conversations and telling stories

What is a language-based learning disability?

Language-based learning disabilities are problems with age-appropriate reading, spelling, and/or writing. This disorder is not about how smart a person is. Most people diagnosed with learning disabilities have average to superior intelligence.

What are some signs or symptoms of a language-based learning disability?

Dyslexia has been used to refer to the specific learning problem of reading. The term language-based learning disability, or just learning disabilities, is better because of the relationship between spoken and written language. Many children with reading problems have spoken language problems.

The child with dyslexia has trouble almost exclusively with the written (or printed) word. The child who has dyslexia as part of a larger language learning disability has trouble with both the spoken and the written word. These problems may include difficulty with the following:

- Expressing ideas clearly, as if the words needed are on the tip of the tongue but won’t come out. What the child says can be vague and difficult to understand (e.g., using unspecific vocabulary, such as “thing” or “stuff” to replace words that cannot be remembered). Filler words like “um” may be used to take up time while the child tries to remember a word.
- Learning new vocabulary that the child hears (e.g., taught in lectures/lessons) and/or sees (e.g., in books)
- Understanding questions and following directions that are heard and/or read
- Recalling numbers in sequence (e.g., telephone numbers and addresses)
- Understanding and retaining the details of a story’s plot or a classroom lecture
- Reading and comprehending material
- Learning words to songs and rhymes
- Telling left from right, making it hard to read and write since both skills require this directionality
- Letters and numbers
- Learning the alphabet
- Identifying the sounds that correspond to letters, making learning to read difficult
- Mixing up the order of letters in words while writing
- Mixing up the order of numbers that are a part of math calculations
- Spelling
- Memorizing the times tables
- Telling time

How is a language-based learning disability diagnosed?

A speech-language pathologist (SLP) is part of a team consisting of the parents/caregivers and educational professionals (i.e., teacher(s), special educators, psychologist). The SLP will evaluate spoken (speaking and listening) and written (reading and writing) language for children who have been identified by their teachers and parents as having difficulty.

For preschool students, the SLP may do any or all of the following:

- Observe the child during classroom activities.
- Evaluate the child’s ability to understand verbal and written directions and to pay attention to written information on the blackboard, daily plans, etc.
- Look for awareness of print. See if the child recognizes familiar signs and logos.
- Watch to see if a child holds a book correctly and turns the pages.
- Determine if the child recognizes and/or writes name.
- Evaluate whether the child demonstrates pretend writing (writing that resembles letters and numbers).
- See if the child recognizes and/or writes letters.
- Have the child tap or clap out the different syllables in words.
- Evaluate if the child can tell whether two words rhyme or give a list of words that rhyme with a specified word.

For the older child, the SLP may also do any or all of the following:

- Observe whether the child can read and understand information on handouts and in textbooks.
- Assess the student’s ability to hear and “play with” sounds in words (phonological awareness skills).
- Have the child put together syllables and sounds to make a word.
- See if the child can break up a word into its syllables and/or sounds (e.g., “cat” has one syllable but three sounds c-a-t).
- Assess the older child’s phonological memory by having him or her repeat strings of words, numbers, letters, and sounds of increasing length.

For all children, the SLP will also provide a complete language evaluation and also look at articulation and executive function.

Executive functioning is the ability to plan, organize, and attend to details (e.g., does he or she plan/organize his or her writing? Is he or she able to keep track of assignments and school materials?).

What treatments are available for people with a language-based learning disability?

The goals of speech and language treatment for the child with a reading problem target the specific aspects of reading and writing that the student is missing. For example, if the student is able to read words but is unable to understand the details of what has been read, comprehension is addressed. If a younger student has difficulty distinguishing the different sounds that make up words, treatment will focus on activities that support growth in this skill area (rhyming, tapping out syllables, etc.).

Individualized programs always relate to the schoolwork. Therefore, materials for treatment are taken from or are directly related to content from classes (e.g., textbooks for reading activities, assigned papers for writing activities, practice of oral reports for English class). The student is taught to apply newly learned language strategies to classroom activities and assignments. To assist the child best, the SLP may work side-by-side with the child in his or her classroom(s).

Intervention with spoken language (speaking and listening) can also be designed to support the development of written language. For example, after listening to a story, the student may be asked to state and write answers to questions. He or she may be asked to give a verbal and then a written summary of the story.

The SLP consults and collaborates with teachers to develop the use of strategies and techniques in the classroom. For example, the SLP may help the teacher modify how new material is presented in lessons to accommodate the child’s comprehension needs. The SLP may also demonstrate what planning strategies the student uses to organize and focus written assignments.

If your child needs language disorder therapy or assistance with language development, Crossroads Speech and Occupational Therapy serves Chicago, the North Shore, and the Northern and Western suburbs. Contact us to schedule a free consultation.